Short hiatus…

Well hello! Wanted to touch base real quick updating you regarding my recent absence… I have been away for the last six weeks or so and ended up not having reliable internet while I was away not to mention the free-time seemed to be non-existent! I am back home now and have a lot of exciting things in the works 🙂 Hopefully will have some time in the near future to update you with some of the intriguing studies and information which I have come across in my recent course of study!

Infinite Joy

I have to confess I struggle with remembering to count my blessings… Especially on days like I have experienced this past week when my sons blood sugar numbers have been all over the map and well outside a ‘normal’ let alone ‘healthy’ range.   But tonight’s middle of the night check is one of those where joy overflows – the kind of joy where you wake up your spouse, you call your best friend in the middle of the night to share great news! Praise our creator!  The joy seems infinite at times like these 🙂  And it’s a joy that one has to share – I give you my joy, take all you need, and take a little extra to give someone else in need…

Top 3 Brain-Boosting Foods Fish: Wild Caught Salmon (Omega-3s – DHA & EPA) Berries: Blueberries, Blackberries (antioxidants) Greens: Bok Choy, Spinach, Collard Greens (folate)

Top 3 Brain Boosting Foods!

One of the common complaints about health is having brain-fog.  We often think this is just a part of aging which we have no control over.  Is that the case? What happens when we look at our brain from a functional perspective?

The simple fact is food affects our brain, for better or worse. Choosing foods which support proper brain function is vital to our overall wellness. Growth of healthy cells, healthy connections in the brain and efficient operation of our brain, and in turn our entire body, are affected by the foods we choose to consume. One of my favorite sayings about brain health comes from Dr. William Sears:

“Forget low-carb and low-fat diets. Eat a ‘right-carb’ and a ‘right-fat’ diet for optimal brain health!”

I couldn’t agree more! The quality of what we eat is of greater importance than the quantity. Let’s take a quick look at our brain health and food choices.top-3-brain-boosting-foods

When our brain is provided with healthy nourishment it can make healthy connections, process information, create memories and signal muscles and hormones to react and move. Next time you think about healthy eating, don’t just think about the benefits it will have on your waistline. Rather, think of all the positive benefits your brain receives from getting the right brain-boosting nutrition!

So what is the fuel which is vital to the brain?

For optimal function our brains need:
Omega-3 fats, Folate, Antioxidants and Carbohydrates.

  • Omega-3s are important building blocks in the brain – they are vital to the proper function of impulses which take place.
  • Folate is a nutrient needed for neurotransmitter function.
  • Antioxidants keep the blood brain barrier healthy, protecting cells from wear and tear and improve blood flow by decreasing excessive blood clotting.
  • Carbohydrates are needed because your brain uses them for energy.

What are quality sources of these brain fuels?

Top 3 Brain-Boosting Foods

Fish: Wild Caught Salmon (Omega-3s – DHA & EPA)
Berries: Blueberries, Blackberries (antioxidants)
Greens: Bok Choy, Spinach, Collard Greens (folate)

One of my family’s favorite meal is grilled salmon with a side of steamed veggies and large bowl of mixed greens topped with a bit of olive oil and berries. Even my child who isn’t fond of fish loves this meal! I have a super simple salmon recipe here. As well as more information on Omega-3s and essential fats here.

So the next time you go shopping remember to stop by the produce and seafood departments to get a special brain-boosting treat 🙂

[Resources:

Soares AA, et al (2017)  A double- blind, randomized, and placebo-controlled clinical trial with omega-3 polyunsaturated fatty acids (OPFA ɷ-3) for the prevention of migraine in chronic migraine patients using amitriptyline.  Nutr Neurosci. doi: 10.1080/1028415X.2016.1266133.

Pu H, Jiang X, Wei Z, Hong D, Hassan S, Zhang W, Shi Y, Chen L, Chen J.(2016) Repetitive and prolonged omega-3 fatty acid treatment after traumatic brain injury enhances long-term tissue restoration and cognitive recovery.
Cell Transplant. doi: 10.3727/096368916X693842. PMID: 27938482

Pu H, Jiang X, Hu X, Xia J, Hong D, Zhang W, Gao Y, Chen J, Shi Y. (2016) Delayed Docosahexaenoic Acid Treatment Combined with Dietary Supplementation of Omega-3 Fatty Acids Promotes Long-Term Neurovascular Restoration After Ischemic Stroke.
Transl Stroke Res. 2016 Dec;7(6):521-534.

Jiraungkoorskul W. Review of neuro-nutrition used as anti-alzheimer plant, spinach Spinacia oleracea. Phcog Rev [serial online] 2016 [cited 2017 Jan 17];10:105-8. Available from: http://www.phcogrev.com/text.asp?2016/10/20/105/194040

The Adventure Begins 

Can’t tell you how many times I have been in such a situation and the countless times that it was a new chapter with an adventure I could never have dreamed of.

This applies to so many areas in our lives, whether work, social, health or families – sometimes what appears to be the end is but a glorious beginning!!!

I am often reminded of the illustration of an infant who leaves the only ‘world’ they have known – and the intensity involved in the birthing process – but what an amazing journey that begins!

MakeItUltra™

When there’s a big disappointment, we don’t know if that’s the end of the story. It may be just the beginning of a great adventure. ~Pema Chödrön


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Cardiovasular Disease & Diabetes: What is the connection?

The primary health concerns of the late 19th and early 20th centuries were infections diseases.  A shift in adverse health came about after the fortification and enrichment of foods.  Chronic diseases, such as heart disease, cancer and stroke became the prevailing ailments.  These diseases continue to rise, some at alarming rates.  Let’s take a quick look between two prevalent diseases today: Heart Disease and Diabetes. I am going to especially look at the incidents in Nacogdoches County in the State of Texas.  [PDF of this post here]

Some quick stats:

nacogdoches-statistics-cvd-and-diabetes

Is this a sign of malfunction in the bodies of the population?

Maintaining a healthy status requires a homeostasis of the bodily systems. Having healthy levels of glucose in our blood is vital for proper balance. When we eat, signals are sent in our body to aid in the metabolizing of the food we just ate.  Insulin is secreted as a result of some of those signals.  It is the “key” which allows glucose to enter the cells.  Without proper signaling of insulin, glucose cannot enter the cells.  This results in glucose going to other parts of the body.  For our body to function properly it is important to keep glucose levels stable.

When our glucose levels are outside a healthy range it attaches to proteins resulting in diabetes-1724617_1920Advanced Glycation End Products (AGEs).  Excessive AGEs leads to plaque forming in the blood vessels.  One consequence is an impairment of the endothelium which lines the blood vessels.  It is hindered in releasing nitric oxide into the blood stream.  With this compromised cardiovascular system, the body has a difficult time repairing daily wear and tear.  Thus an increase in inflammation.  Heart disease often ensues.

In fact…. Studies have shown an increased incidence of heart disease in the presence of diabetes! 

With a high prevalence of heart disease and diabetes there is a need to understand the role of a proper functioning body. In regards to diabetes and cardiovascular disease the role of glucose balance is of marked importance.  Maintaining proper levels eliminates an exacerbating risk factor for both diabetes and cardiovascular disease.  A body which is in homeostasis is free of disease contrasted with a body where malfunction is present, disease emanates.

What can you do today to ensure a proper functioning body?

Begin practicing the 5 Pillars to Healthy Function!!!

Eat Quality Foods

Get Adequate Sleep

Be Active

Promote Healthy Digestion

Embrace Peace & a Spiritual Connection (Eliminate Stress)

push-ups-888024_1280

Related Research:

A.G.E. Foundation. What are AGEs http://agefoundation.com/age/

CDC Interactive Atlas of Heart Disease and Stroke TablesGeographic Area 2010-2012.

Davis, C., and E. Saltos. (May 1999) “Dietary Recommendations and How They Have Changed Over Time,” America’s Eating Habits: Changes and Consequences, Agriculture Information Bulletin No. 750, USDA, ERS. Chapter 2.

Texas Department of State Health Services. (2012). 2012 Texas Heart Disease and Stroke

Fact Sheets, (2013). Diabetes Prevalence Among Adults BRFSS data Tables

Yamagishi, S-i., Nakamura, N., and Matsui, T. (2016) Glycation and cardiovascular disease in diabetes: A perspective on the concept of metabolic memory. J Diabetes, doi: 10.1111/1753-0407.12475.

9 Tests for Cardiovascular Risk Assessment

If you are reading this chances are you are looking for something more than the standard tests for diagnosing heart disease.  My guess would be you have a desire to get to the underlying causes and factors of your state of health.  I would further venture to say you are also looking at ways to prevent adverse health. I am going to quickly touch on Cardiovascular Assessment in this post.

Heart disease is at the top of the list of health issues in the United States and a growing concern for younger adults. There are several tests available that will dig deeper into the function inside your body and provide us with warnings adverse health is on its way.  These tests are indicators of potential malfunction and impending consequences of the disruption of proper balance.  To get a better look at what is going on ask your healthcare provider for the following tests:

  • Total Cholesterolbody-116585_1280

  • LDL Cholesterol

  • HDL Cholesterol

  • Triglycerides

  • LDL Density Patterns

  • C-Reactive Protein

  • Homocysteine

  • Lp (a)

  • Fibrinogen

Some of these you are probably already familiar with such as the Cholesterol and Triglycerides.  You may be wondering – Why the other tests?  What makes them significant?

C-reactive protein is a protein which indicates inflammation in the body.  This test is a strong risk predictor of future heart attack and/or stroke. It is important to note past or current infections can increase the levels of this protein.

Homocysteine is an amino acid which can injure the lining of blood vessels, thus triggering deposits and atherosclerosis. One study found that men with high homocysteine had 3 times greater risk of heart attack!

Lipoproteins are lipids and proteins that are transported through your bloodstream in ‘packages’. One of these is Lipoprotein(a) [Lp(a)] Lipoprotein(a) is a marker for predicting the severity of future heart disease. This is often strongly influenced by heredity.

Fibrinogen is an important agent in the process of the formation of blood clots.  Again, elevated levels are linked to heart disease and/or stroke.

Each of these areas are affected by our diets and lifestyles.  Making changes in our habits can greatly affect the damage from elevated ‘warning lights’.  Be sure to ask your provider for ways to return a healthy homeostasis in your body!

A few quick tips are:

  • Eat Real foods, avoid packaged and processed foods
  • Get plenty of water daily!
  • Get plenty of rest and relaxation daily!
  • Exercise – the best exercise is the one you will do 🙂 Start low and go slow

As always, comments, questions welcomed and I hope this has been beneficial to you or a loved one!

 

[Relevant Research:

Cantin B, Despres JP, Lamarche B, Moorjani S, Lupien PJ, Bogaty P, Bergeron J, Dagenais GR. Association of fibrinogen and lipoprotein(a) as a coronary heart disease risk factor in men (The Quebec Cardiovascular Study). Am J Cardiol. 2002 Mar 15;89(6):662-6.

Lamarche B, St-Pierre AC, Ruel IL, Cantin B, Dagenais GR, Despres JP. A prospective, population-based study of low density lipoprotein particle size as a risk factor for ischemic heart disease in men. Can J Cardiol. 2001 Aug;17(8):859-65.

Blake GJ, Ridker PM. Novel clinical markers of vascular wall inflammation. Circ Res. 2001 Oct 26;89(9):763-71.

Clarke R, Lewington S, Donald A, Johnston C, Refsum H, Stratton I, Jacques P, Breteler MM, Holman R. Underestimation of the importance of homocysteine as a risk factor for cardiovascular disease in epidemiological studies. J Cardiovasc Risk. 2001 Dec;8(6):363-9.

Matsumoto Y, Daida H, Watanabe Y, Sunayama S, Mokuno H, Yokoi H, Yamaguchi H. High level of lipoprotein(a) is a strong predictor for progression of coronary artery disease. J Atheroscler Thromb. 1998;5(2):47-53.

von Eckardstein A, Schulte H, Cullen P, Assmann G. Lipoprotein(a) further increases the risk of coronary events in men with high global cardiovascular risk. J Am Coll Cardiol. 2001 Feb;37(2):434-9.

Austin MA. Plasma triglyceride as a risk factor for cardiovascular disease. Can J Cardiol. 1998 May;14 Suppl B:14B-17B.

Got Cravings? What to eat instead…

Anyone who has made changes to their diet has probably experienced cravings! I came across a similar chart a few years ago and it has been a huge help when I go through times of craving foods I know are not a healthy choice!!!  Here is my rendition and hope it is beneficial to you in your health journey 🙂

cravings-what-to-eat-instead

I’ve been diagnosed with an Autoimmune: 4 tips to reclaim your health

So many diets, so many protocols, where do we start???  I’m allergic to this, sensitive to that, it’s complicated, I don’t have those ingredients…  it is just too overwhelming!  Can you relate to any of those statements?  {This is where we were two years ago}

What can we do when we realize we have an autoimmune disease.  Specifically what is it that we can do that also supports a calm lifestyle? You know, one without stress?  Here are some of the basics which are found in nearly every protocol for reclaiming your health.

  • Bone broth
  • Prebiotics & Probiotics
  • Fermented foods, such as sauerkraut
  • Relaxing time

Why these?  Malfunction most often originates in our digestive system.  To restore that system think of what we would do for our children when they were sick.  Soup, right?  Broth, right?  Why?  It is gentle and nourishing!  4-keys

So – What about the others?  Well, prebiotics, probiotics and fermented foods help to repopulate our microbiome with healthy bacteria.  Several studies have shown a link between autoimmune and a disruption in the digestive tract flora.  Restoring proper flora is another beneficial, and necessary component to reclaiming health.

Which leaves us with rest and relaxation.  Moms – I know you have that instinct that tells you when your child needs to rest just a little bit more.  We instruct our sick child to take it easy, rest just a little bit more… Somehow we forget that applies to us as adults as well 🙂 When our body is in a state of stress, exhaustion and overworked it doesn’t have time to repair and spend energy on repairing.  Priorities get out of whack!  It sounds soo simple yet I have spent a good amount of time brushing off this aspect – only to find myself spinning wheels wondering why I am not seeing the results I expected.   I have found it to be extremely refreshing to spend 10-15 mintues a day sitting in quiet, solitude while I take deep breaths in(counting to 5) holding for count of 5 and then exhaling (count of 5).

We are all individuals and have different stressors and underlying causes which will require an individualized plan of action.  The four things mentioned above are at the core of nearly all plans.  These four tips can help calm down a stressed and overworked digestive system, helping to smooth the road on your journey to better health!  If you are looking to take your health to the next level and would like help formlating a customized plan you can get in touch with me on my contact page!

This Blood Test Predicts Death, Even When Everything Else Looks “Great” (Re-blog: Functional Medicine University)

This Blood Test Predicts Death, Even When Everything Else Looks “Great”

Ronald Grisanti D.C., D.A.B.C.O., D.A.C.B.N., M.S.

As I discussed in a recent article, I mentioned the prognostic power of the blood test brain natriuretic peptide (BNP).

Remember there is a 25% increase in death if the BNP is elevated one year after a heart attack. And don’t forget a BNP persistently over 80 pg/mL can be an important indicator of when a more invasive approach is needed such as bypass surgery.

In fact, a BNP twice the normal range can indicate a quadruple risk of death in folks who don’t even have symptoms. There is no other test that has the ability to have this crystal ball power of determining your chances of succumbing to heart failure even if you have no symptoms.

As a brief explanation, BNP is a neuro-hormone made in and released from the heart ventricle. The ventricles of the heart make up the biggest part of the heart muscle that squeezes blood through all the rest of the body. When the ventricles are under too much tension or the work load on the ventricles is too much the BNP goes up.

Basically, if the heart is working overtime to function, the BNP is made in larger quantities to help rescue the heart. The key thing to remember is the BNP will commonly increase long before you have any signs or symptoms that you have any trouble. This is one reason to make sure you keep your blood pressure well within normal levels because it reduces stress on the ventricles

What I find so disturbing is the fact that this is not a new test. It has been around for decades. Can you believe that most cardiologists are not aware of it and if they are, they still don’t order it? blood-1761832_1920

On the other hand knowledgeable “research” cardiologists over ten years ago published in the Journal of the American Medical Association stated the BNP test “was a stronger biomarker for cardiovascular disease and death than the C-Reactive Protein”.

One of the reasons you have not heard more about this test is because there is no drug the pharmaceutical has to treat the elevated BNP.

It is important to understand that a normal BNP according to the traditional medical think should not indicate that you are ok. Studies show that you have a ten-fold risk of early death if you’re in the fourth quintile or in other words in the top ¼ of the normal range, but still in “normal”. Others have shown a 50% increase in death in the fourth quintile while others have shown 20% increase in death above the fourth quintile.

The main point I want to make is to insist your doctor orders the BNP/pro-BNP test to determine if you are heading toward heart failure.

Clearly the BNP has provided information about the risk of dying than no other test can, yet it has been persistently ignored. The leading cardiology journal says, “Serial determinations of BNP levels during outpatient follow-up after acute coronary syndrome predicts the risk of death or new congestive heart failure.

How to treat an elevated BNP

I will now show you natural nutrients that down-regulate the BNP.

The solution is taking real vitamin E which includes four tocopherols and four tocotrienols (alpha, beta, gamma, and delta).

It turns out that the tocotrienols is a precursor to natriuretic hormone and is an essential part of what the body uses to make BNP to help heal the heart. The sad thing is if you ask your cardiologist or other doctor about tocotrienols, most have never even heard of them, even though they are crucial for treating an abnormal BNP. And of course this is not new, as it has been known for over a decade that gamma tocotrienols can lower BNP.

Don’t forget tocotrienols are necessary for fighting cancers making cancer cells commit suicide and stopping metastases. In fact, tocotrienols have been shown to stop the growth of human breast cancer cells, improve blood pressure, prevent abnormal clotting, improve diabetes and much more. Name one medication that does all of that! Instead we have cardiologists and oncologists who have never heard of tocotrienols and do not prescribe this absolutely necessary nutrient to people who need it the most.

One of the other parts of vitamin E, gamma tocopherol also lowers the BNP. And this one as well as the gamma tocotrienol are usually low in patients with coronary heart disease. Be careful that you stay away from plain generic “vitamin E” (which is usually synthetic alpha-tocopherol) which actually lowers the gamma tocotrienols. Always check your multi vitamin and see if it only contains alpha-tocopherol, one of 8 parts of vitamin that you see advertised on TV because they will drive down the other forms of E that are not in it. Get rid of it.

So again what do you do for your elevated BNP ?

First thing is to make sure you have good levels of the eight forms of vitamin E.
{You are probably wondering WHERE do I get a balanced supplement?  Well – here is a linkcapsule that has a great spreadsheet with details of the different supplements Toxinless.com}

BNP also responds to low salt. Change your salt to a potassium salt substitute, available in all grocery store.

The bottom line? The BNP blood test shows risk even when all other tests are normal and even when the person has no symptoms. So after you have ordered your BNP and Pro-BNP, then do not hesitate to take the complete vitamin E and also request your doctor orders a Cardio/ION. Might as well get the best test to get an accurate status on your other heart markers and know what to do to treat any of the abnormal findings.

References

Weidemann A, et al, Hypoxia, via stabilization of the hypoxiainducible factor HIF-1a, is a direct and sufficient stimulus for brain-type natriuretic peptide induction, Biochem J, 409:233-42, 2008 (predicts before symptoms, also useful for cancer hypoxia as well as heart)

  • Rogers Sherry, Total Wellness, Prestige Publishing, May 2013

Lorgis L, et al, High levels of N-terminal pro B-type natriuretic peptide are associated with ST resolution failure after reperfusion for acute myocardial infarction, Q J Med, 100:211-16, 2007 (better predictor than ejection fraction, level over 900 means EKG ST damage not resolved, hypoxia leads to CHF)

James SK, et al, N-terminal pro-brain natriuretic peptide and other risk markers for the separate prediction of mortality and subsequent myocardial infarction in patients with unstable coronary artery disease: a Global Utilization of Strategies To Open Occluded Arteries (GUSTO)-IV substudy, Circulation 108:275-81, 2003

Tapanainen JM, et al, Natriuretic peptides as predictors of non-sudden and sudden cardiac death after acute myocardial infarction in the beta-blocking era, J Am Coll Cardiol 43; 5:757-63, 2004

Omland T, et al, B-type natriuretic peptide and long-term survival in patients with stable coronary artery disease, Am J Cardiol, 95:24-8, 2005

Morita E, et al, Increased plasma levels of brain natriuretic peptide in patients with acute myocardial infarction, Circulation, 88:82-91, 1993

Morrow DA, NACB Writing Group, National Academy of Clinical Biochemistry laboratory medicine practice guidelines: clinical characteristics and utilization of biochemical markers in acute coronary syndromes, Circulation 115: e356-75, 2007

Omland T, et al, N-terminal pro-B-type type natriuretic peptide and longterm mortality in acute coronary syndromes, Circulation 106:2913-8, 2002

Morrow DA, Prognostic value of serial B-type natriuretic peptide testing during follow-up of patients with unstable coronary artery disease, J Am Med Assoc 294:2866-71, 2005

Richards M, et al, Comparison of B-type natriuretic peptides for assessment of cardiac function and prognosis in stable ischemic heart disease, J Am Coll Cardiol, 47:52-60, 2006

Richards AM, et al, B-type natriuretic peptides and ejection fraction for prognosis after myocardial infarction, Circulation 107:2786-92, 2003

Kragelund C, et al, N-terminal pro–B-type natriuretic peptide and long-term mortality in stable coronary heart disease, New Engl J Med 352:666-75, 2005

Kistorp C, et al, N-terminal pro-brain natriuretic peptide, C-reactive protein, and urinary albumin levels as predictors of mortality and cardiovascular events in older adults, J Am Med Assoc, 293:1609-16, 2005

Harma N, et al, Rapid ventricular induction of brain natriuretic peptide gene expression and experimental acute myocardial infarction, Circulation 92:1558- 64, 1995

Saito H, et al, Gamma-tocotrienol, a vitamin E homolog, is a natriuretic hormone precursor, J Lipid Res, 44;8:1530-5, 2003 (a decade ago!)

Hattori A, et al, Production of LLU-a following an oral administration of gamma-tocotrienols to rats, Biol Pharm Bull 23; 11:1395-7, 2000

Parker RA, et al, Tocotrienols regulate cholesterol production in mammalian cells by post-transcriptional suppression of 3-hydroxy3- methyl glutaryl coenzyme A reductase, J Biolog Chem 268; 15:11230-8, 1993 (2 decades ago!)

Inokuchi H, et al, Anti-angiogenic activity of tocotrienols, Biosci Biotechnol Biochem 67:7:1623-27, 2003

Wan Nazaimoon WM, et al, Tocotrienols-rich diet decreases advanced glycosylation end products in non-diabetic rats and improves glycemic control in streptozotocin-induced diabetic rats, Malaysian J Pathol 24; 2:77-82, 2002

Sylvester PW, et al, Role of GTP-binding proteins in reversing the anti-proliferative effects of tocotrienols in preneoplastic mammary epithelial cells, Asia Pacific J Clin Nutr 11 (suppl 7): S452-9, 2002

Steiner M., Vitamin E: more than an antioxidant, Clin Cardiol 16 (4 suppl 1): 116-8, 1993

Newaz MA, et al, Effect of gamma tocotrienols on blood pressure, lipid peroxidation and total antioxidant status in spontaneously hypertensive rats (SHR), Clin Exper Hypert (New York) 21; 8:1297-1313, 1999

Nakagawa K, et al, DNA chip analysis of comprehensive food function: inhibition of angiogenesis and telomerase activity with unsaturated vitamin E, tocotrienol, BioFactors 21; 1-4:5-10, 2004

Ohrvall M, et al, Gamma, but not alpha, tocopherol levels in serum are reduced in coronary heart disease patients J Intern Med, 239:111-7, 1996

Uto-Kondo H, et al., Gamma tocopherol accelerated sodium excretion in a dose dependent manner in rats with a high sodium intake, J Clin Biochem Nutr 41: 211-17, Nov 2007

Uto H, et al, Gamma-tocopherol enhances sodium excretion as a natriuretic hormone precursor, J Nutr Sci Vitaminology 50:277-82, 2004

Kantoci D, et al, Endogenous natriuretic factors 6: the stereochemistry of a natriuretic gamma tocopherol metabolite LLU-a, J Pharmacol Exper Therap 282:648-56, 1997

Murray EED, et al, Endogenous natriuretic factors 7: Biospecificity of a natriuretic gamma tocopherol metabolite LLU-a, J Pharmacol Exper Therap 282 657-62, 1997

Before prescribing treatment, FMU recommends that you follow the standard of care of your profession, as well as confirm the information contained herein with other sources.

Functional medicine embraces the totality of the regulatory functions of the body. It encompasses all of the biophysical, biochemical, enzymatic, endocrine, immunological, and bioenergetic regulatory capacities.

Ronald Grisanti D.C., D.A.B.C.O., D.A.C.B.N., M.S.

Compliments from Functional Medicine University

http://www.functionalmedicineuniversity.com/public/department88.cfm